KMAN Publication Inc. Quality of Life and Health Sciences 2 Serial Number 3 2026 01 01 Illness Perception and Health-Related Quality of Life Among Patients With Type 2 Diabetes: The Mediating Role of Diabetes Distress and the Moderating Role of Perceived Social Support Illness Perception and Health-Related Quality of Life Among Patients With Type 2 Diabetes: The Mediating Role of Diabetes Distress and the Moderating Role of Perceived Social Support 1 15 10.61838/7c9vvk80 EN Journal Article <table> <tbody> <tr> <td> <p><strong>Objective:</strong> This study aimed to examine the relationship between illness perception and health-related quality of life among patients with type 2 diabetes, with diabetes distress as a mediator and perceived social support as a moderator.</p> <p><strong>Methods and Materials: </strong>This cross-sectional descriptive-correlational study was conducted among 384 adult patients with type 2 diabetes receiving outpatient care in Georgia. Participants were selected through convenience sampling from diabetes and endocrinology clinics in Tbilisi, Kutaisi, and Batumi. Data were collected using a demographic and clinical information form, the Brief Illness Perception Questionnaire, the Diabetes Distress Scale, the Multidimensional Scale of Perceived Social Support, and the 12-Item Short Form Health Survey. Data were analyzed using SPSS version 27 and AMOS version 24. Descriptive statistics, Pearson correlation coefficients, mediation analysis, moderation analysis, and moderated mediation modeling with 5,000 bootstrap samples were used. Age, gender, duration of diabetes, and diabetes-related complications were entered as control variables.</p> <p><strong>Findings: </strong>Illness perception was positively associated with diabetes distress and negatively associated with health-related quality of life. Diabetes distress was negatively associated with health-related quality of life, while perceived social support was positively associated with health-related quality of life and negatively associated with diabetes distress. Mediation analysis showed that diabetes distress partially mediated the relationship between illness perception and health-related quality of life. Moderation analysis showed that perceived social support weakened the relationship between illness perception and diabetes distress and also reduced the negative effect of diabetes distress on health-related quality of life. The conditional indirect effect was strongest among patients with low perceived social support and weakest among those with high perceived social support.</p> <p><strong>Conclusion: </strong>The findings indicate that threatening illness perceptions reduce health-related quality of life partly by increasing diabetes distress, while perceived social support buffers this adverse psychological pathway. Integrating distress screening, illness perception modification, and social support enhancement into diabetes care may improve patients’ quality of life.</p> </td> </tr> </tbody> </table> <p> </p> https://journals.kmanpub.com/index.php/qlhs/article/download/5786/11155